HVO Volunteer Provides Service Through Education

In February 2018, Germaine Fritz, DO, traveled to Makerere University’s Mulago Hospital in Kampala, Uganda, to educate and train residents and staff of the hospital’s orthopaedics department. It was the ninth country that Dr. Fritz, a hand surgeon, has visited with Health Volunteers Overseas (HVO)—a nonprofit organization dedicated to improving global health through education.

“It’s among the best places I’ve volunteered,” she said.

Dr. Fritz became interested in volunteering in Uganda after attending the HVO-hosted Orthopaedics Overseas luncheon at the AAOS 2016 Annual Meeting. During the luncheon, Isaac Kajja, MD, head of orthopaedics at Mulago Hospital, issued a call for volunteers to bring education and opportunity to his staff.

“Dr. Kajja and his presentation were very positive,” said Dr. Fritz. “I’m always looking for where I should go next and who has the greatest need. I’m giving up time from work, so I want to be sure the experience is valuable for them and for me.”

Dr. Kajja has often emphasized the essential role he sees for HVO volunteers in his department. Leading up to his attendance at the 2016 AAOS Annual Meeting, he wrote, “Working with HVO will assist the staff and my institutions in a number of ways: impart knowledge and skills to staff, improve collaborative research between my university and international partner universities, and [further] development of orthopaedic subspecialties at Makerere teaching hospital in Mulago.”

Dr. Fritz found that her assignment in Uganda enabled her to do all that and more.

“There were lots of opportunities to teach. The residents were very interested, very motivated,” she said. “Another thing that impressed me was that the [orthopaedic] attending physicians were also very interested in learning. It wasn’t just the residents.”

Lectures, labs, and more

Dr. Fritz traveled to Uganda with two senior residents—Ryan Nielsen, DO, and Andrew Smith, DO. On the first day of their assignment, the team met with Dr. Kajja to develop an education plan for their two-week stay.

“Between the three of us, we provided two hours of lecture every morning. Residents came in every morning between 7 and 7:30 a.m. They normally don’t start their day until 9 a.m. or later,” noted Dr. Fritz. “They came because we were there.”

As one of the first hand surgery experts to volunteer at Mulago Hospital, Dr. Fritz had ample information to share with residents and staff. But she and her team didn’t just talk for two hours every morning—they offered plenty of opportunities for hands-on learning.

“I have a kind of lab where I staple some material that simulates flexor and extensor tendons and little nerve branches on cardboard,” said Dr. Fritz. “I help the residents learn how to sew smaller structures, and there are certain tendon-repair techniques that show them. I would draw it out on some cardboard. They took pictures of the cardboard; they were into it.”

Dr. Fritz always strives to make her lessons effective and fun.

“I try to make the education a little different, so it’s not just a lecture, and I don’t just read them slides,” Dr. Fritz said. “Toward the end of the two-week period, we play orthopaedic jeopardy. I have a jeopardy game that I create from the lectures we’ve given. We divide the residents into teams, and I have little prizes for the winners. They just love it. It’s fun and a different way of providing education.”

In addition to lectures, labs, and jeopardy challenges, Dr. Fritz’s team provided hands-on training during exams and surgery. In one case, Drs. Nielsen and Smith demonstrated a new technique to the Ugandan residents. It was a particularly successful teaching opportunity.

“There was a surgical procedure that they wanted to perform, based on their examinations, on two children with spastic problems in their lower extremities,” said Dr. Fritz. “I told them if they felt that they could teach it to the local residents, they should—and so they did.”

“On each of the two patients, [Drs. Smith and Nielsen] demonstrated the procedure on the right leg,” Dr. Fritz noted. “They then gave the knife to a local resident and walked them through the procedure; the resident performed the procedure on the left leg and knew exactly what to do. It was a great learning experience.”

Dr. Fritz noted that the experience also had a positive impact on Drs. Nielsen and Smith.

“Both physicians increased their awareness of orthopaedics in a different way,” she said. “Their surgical skills and their teaching skills blossomed because they were able to show Ugandan residents things that they knew. The best way to learn is to teach somebody. They did a great job.”

Dr. Fritz plans to return to Mulago Hospital in 2019 to build on the training that her team undertook earlier this year, and she encourages others to consider their own volunteer assignments.

“My volunteer experience has been a wonderful part of my practice life. It’s everything I like about orthopaedics and nothing that I don’t,” she said.

HVO has many short-term volunteer opportunities available including projects in Bhutan, Bolivia, China, Costa Rica, Ghana, Malawi, Myanmar, Nicaragua, the Philippines, St. Lucia, Tanzania, and Uganda. Assignments generally last two to four weeks and volunteers are placed throughout the year. Senior orthopaedic residents interested in volunteering at project sites may apply for the Orthopaedics Traveling Fellowship.